Association of Intravenous Methylprednisolone With Immune Response and Clinical Outcomes in Children With Mycoplasma pneumoniae Pneumonia: A Retrospective Cohort Study.

This retrospective cohort study investigated the effect of intravenous methylprednisolone on immune outcomes in 624 children with Mycoplasma pneumoniae pneumonia (MPP) admitted from April 2023 to April 2025. Data were retrospectively extracted from electronic medical records. Based on treatment received, patients were divided into control (azithromycin-based therapy) and observation (additional methylprednisolone) groups. After treatment, the observation group showed significantly higher CD4⁺ and CD4⁺/CD8⁺ levels, lower CD8⁺ levels, greater reductions in IL-6 and IL-8, and greater increase in IL-10 compared with controls (all P < .05). Symptom resolution times were significantly shorter in the observation group (P < .05). Adverse reaction rates were similar between groups (11.54% vs 15.38%, P > .05). Adding intravenous methylprednisolone to standard therapy was associated with improved immune and inflammatory markers, faster symptom resolution, and good tolerability in children with MPP. Prospective trials are needed to validate these findings.